Assignment:Clinical Training Assignment:Clinical Training
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Assignment:Clinical Training
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Level of Clinical Training:
FORMCHECKBOX Pre-clinical training; coursework only
FORMCHECKBOX 0-12 months FORMCHECKBOX 12-24 months FORMCHECKBOX 2+ years
Rating Scale
4=Outstanding: Strong mastery of skills and thorough understanding of concepts
3=Mastered Basic Skills at Developmental Level: Understanding of concepts/skills evident
2=Developing: Minor conceptual and skill errors; in process of developing
1=Deficits: Significant remediation needed; deficits in knowledge/skills
NA=Not Applicable: Unable to measure with given data (do not use to indicate deficit)
| 4: Outstanding | 3: At Level | 2: Developing | 1: Deficits | Comp | Score | |
| Introduction | FORMCHECKBOX Detailed intro that identifies client, age, ethnicity, etc.
FORMCHECKBOX Descriptions useful for understanding problem |
FORMCHECKBOX Identifies basic information: significant others, age, ethnicity, occupation, grade, etc. | FORMCHECKBOXMissing 1-2 identifiers
FORMCHECKBOXDoes not identify any significant others |
FORMCHECKBOXMissing, incorrect or significant problem with identifiers and/or significant involved parties | 2.3.7 | FORMDROPDOWN
FORMCHECKBOXNA |
| Presenting Concern | ||||||
| Presenting Concern
|
FORMCHECKBOX Descriptions provides detailed, fair description of all stakeholder’s views
FORMCHECKBOX Thoughtful identification of stakeholders FORMCHECKBOX Word choice conveys empathy FORMCHECKBOX Begins to build clear conceptualization |
FORMCHECKBOX Clear description of problem for each person and key stakeholders
FORMCHECKBOX Sufficient description for case conceptualization |
FORMCHECKBOXMinor problems or lack of clarity with problem descriptions
FORMCHECKBOX Missing stakeholders |
FORMCHECKBOXSignificant problems with problem descriptions
FORMCHECKBOX Missing key perspectives; incorrect characterization |
2.3.9 | FORMDROPDOWN
FORMCHECKBOXNA |
| Background and History | ||||||
| Background Information | FORMCHECKBOX Skillfully discusses trauma and substance issues
FORMCHECKBOX Includes detailed summary of recent and past events FORMCHECKBOX Begins to build clear conceptualization |
FORMCHECKBOX Identifies salient trauma and substance abuse issues
FORMCHECKBOXProvides clear overview of history |
FORMCHECKBOXMisses trauma or substance use issues
FORMCHECKBOXInsufficient, vague, minimal or missing background information |
FORMCHECKBOXSignificant information missing
FORMCHECKBOX Unable to identify significant events |
2.3.7 | FORMDROPDOWN
FORMCHECKBOXNA |
| Strengths and Diversity | ||||||
| Client/
Family Strengths and Diversity |
FORMCHECKBOX Detailed and useful description of all forms of strengths
FORMCHECKBOX Meaningful discussion of diversity resources and limitations |
FORMCHECKBOXIdentifies at least one of each form of strength
FORMCHECKBOX Identifies at least one diversity resource and limit |
FORMCHECKBOXUnderdeveloped description of strengths
FORMCHECKBOXMisses diversity resources and limits |
FORMCHECKBOXSignificant problems identifying clinically relevant strengths
FORMCHECKBOX Misses significant diversity resources and limits |
2.3.8 | FORMDROPDOWN
FORMCHECKBOX NA |
| Family Structure | ||||||
| Boundaries | Detailed assessment of:
FORMCHECKBOX Family life cycle FORMCHECKBOX Boundaries FORMCHECKBOX Triangles/Coalition FORMCHECKBOX Hierarchy FORMCHECKBOX Complementary patterns |
Clear assessment of:
FORMCHECKBOX Family life cycle FORMCHECKBOX Boundaries FORMCHECKBOX Triangles/Coalition FORMCHECKBOX Hierarchy FORMCHECKBOX Complementary patterns |
Minor problems with:
FORMCHECKBOX Family life cycle FORMCHECKBOX Boundaries FORMCHECKBOX Triangles/Coalition FORMCHECKBOX Hierarchy FORMCHECKBOX Complementary patterns |
Significant problems:
FORMCHECKBOX Family life cycle FORMCHECKBOX Boundaries FORMCHECKBOX Triangles/Coalition FORMCHECKBOX Hierarchy FORMCHECKBOX Complementary patterns |
1.1.1
2.1.1 2.2.3 6.3.2 |
FORMDROPDOWN
FORMCHECKBOX NA |
| Interaction Patterns | ||||||
| Problem Interaction Pattern | FORMCHECKBOX Detailed, insightful description of interaction sequence
FORMCHECKBOX Detailed, insightful systemic hypothesis FORMCHECKBOX No member blamed |
FORMCHECKBOX Clear, behavioral description of interaction behavioral sequence
FORMCHECKBOX Clear, useful systemic hypothesis |
FORMCHECKBOX Vague, non-behavioral description of interaction pattern
FORMCHECKBOX Hypothesis vague or non-systemic |
FORMCHECKBOX Unclear interaction pattern
FORMCHECKBOX Problems with hypothesis FORMCHECKBOX One member blamed for problem |
1.1.1
2.2.3 |
FORMDROPDOWN
FORMCHECKBOX N |
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